Provider Demographics
NPI:1316643794
Name:COON, JOSHUA (EDD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:COON
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 ESCALANTE DR # 203
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-8931
Mailing Address - Country:US
Mailing Address - Phone:970-422-1761
Mailing Address - Fax:
Practice Address - Street 1:1305 ESCALANTE DR # 203
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-8931
Practice Address - Country:US
Practice Address - Phone:970-422-1761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor